Species Specific One of the strongest arguments for the superiority of human milk in infant feeding is the way the milk of each species of mammal is specifically tailored to the unique growth needs of its young. So specialized is the process of lactation that the composition of the milk, the location and number of nipples, and the frequency of feedings all are designed to optimize the survival and development of the offspring. In general, the nutrient content of a particular mammal's milk is directly related to the rate at which the newborn doubles its birth weight. Mammals with more dilute milks typically feed their young at close intervals, while those with more nutrient-dense milks feed less frequently. Aquatic and cold-weather mammals, like whales and polar bears, produce milk with an extremely high fat content to ensure sufficient calories to maintain an insulating layer of blubber. Human babies are among the most immature mammalian newborns, completely dependent on adults for care and survival. Human babies also have one of the slowest rates of growth, taking about four and a half months to double their birth weight. As expected, human milk is among the most dilute of all mammalian milks, and our feeding pattern is a frequent one-every couple of hours around the clock. This frequent feeding schedule provides an additional benefit. Each time the baby is positioned to nurse, the distance between his eyes and his mother's face is ideal for allowing him to focus well. An intimate bond is forged during the feeding process, ensuring the close, attentive parental care necessary for survival and growth.

Inadequacies of Infant Formulas While mother's milk is the gold standard upon which all infant formulas are modeled, it is impossible to create an infant formula that exactly mimics your own milk. For one thing, all the ingredients in human milk have not been fully identified. Scientists are constantly discovering new properties in human milk that are absent in formulas, or are gaining new understandings about the function of a previously known component of human milk. Whenever it is possible to add an essential ingredient to formulas, manufacturers scramble to modify their product to more closely resemble human milk. While I am grateful that infant formulas are available for those instances when they are needed, we must never lose sight of the fact that human milk is uniquely superior to any breast milk substitute and it is impossible to precisely match-no matter how many times a product is "improved."

We also must remember that many components of breast milk simply cannot be incorporated into formulas. Although manufacturers are able to produce formulas containing approximately the same percentage of protein, fat, and carbohydrate found in human milk, the quality of each of these nutrients differs significantly from the composition of breast milk. Even minor differences between human milk and formula could have important consequences since a newborn is totally dependent on a single food during a critical period of growth and development.

Finally, remember that formulas are based on cow's milk, and it is virtually impossible to change the milk from one mammal into that of another. Thus, no formula will ever be able to exactly duplicate your own milk. Even if clever advertising messages try to convince you that a particular formula is "closest to mothers' milk," infant formulas actually represent a distant second choice.

When a mother decides to breastfeed, she doesn't have to worry whether her baby will tolerate her milk, whereas many formula-feeding mothers have discovered too late that their babies can't tolerate human milk substitutes. Few things are more discouraging to new parents than having a baby with a formula intolerance and being unable to find a formula that agrees with him.

Breastfeeding confers valuable protection against infant illnesses, including diarrhea and respiratory infections. Breast milk contains many substances that benefit your baby's immune system, including antibodies, enzymes, white blood cells, and other factors. Antibodies against germs to which the mother recently has been exposed appear in her milk a short time later to protect her baby against the same infecting organisms. Breastfeeding provides the greatest protection against illness in developing countries. However, even in the United States and other developed nations, the protective effect of breastfeeding is significant against diarrhea, ear infections, pneumonia, and other illness.

For a middle-class baby in America, childhood infections cause discomfort and inconvenience and only rarely produce life-threatening consequences. In developing countries, however, formula-fed infants face a dramatic increased risk of suffering malnutrition, infection, and death when formula is prepared using contaminated water and diluted excessively. Women in the United States serve as influential role models for disadvantaged women worldwide. I strongly believe that American women are obligated to strengthen the global message that breastfeeding is highly desirable in every culture and is something to be cherished by women the world over.

Diarrhea. Infant diarrhea is a major cause of childhood illness in the United States, resulting in more than a million office visits, two hundred thousand hospitalizations, and about three hundred deaths each year. It has long been recognized that breastfed infants have far fewer bouts of diarrhea and vomiting than formula-fed babies. If a breastfed infant does develop an intestinal illness, continued nursing usually is well tolerated and the duration of illness is shortened. The protective effect of human milk against diarrhea is greatest while a baby is exclusively breastfed.

Premature infants are particularly susceptible to a serious, potentially life-threatening bowel infection known as necrotizing enterocolitis (NEC). Several studies, including a large, multicentered study of nearly one thousand infants, have found that NEC occurred more commonly in premature infants who were solely formula-fed compared to those who were fed breast milk alone.

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